Prior Authorization Specialist

A company is looking for a Prior Authorization Specialist, responsible for managing prior authorization requests for medications and supplies.

Key Responsibilities

Initiate, process, and oversee clinical review of prior authorization requests, ensuring compliance with payer requirements

Collaborate with healthcare providers, insurance companies, and patients to gather necessary clinical information for submissions

Submit prior authorization requests accurately and timely using electronic submission platforms

Required Qualifications

High School Diploma or GED, or licensed / registered pharmacy technician, or previous pharmacy experience

1+ years of pharmacy experience

Knowledge of pharmacy or healthcare-related terminology

Familiarity with pharmacy terminology including sig codes, Roman numerals, and brand / generic medication names

Basic math and analytical skills, along with intermediate typing / keyboard skills